Basic Information
| Provider Information | |||||||||
| NPI: | 1376524314 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | METZGER | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5 TARKILN RD | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023641250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7815852200 | ||||||||
| FaxNumber: | 7815851784 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2005 | ||||||||
| LastUpdateDate: | 01/21/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 156683 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 156683 | 01 | MA | TUFTS | OTHER | 03179702 | 05 | MA | MEDICAID | 04 2297845 | 01 | MA | TRICARE | OTHER | 5972719 | 01 | MA | AETNA | OTHER | 04 2297845 | 01 | MA | HCVM | OTHER | 0016433 | 01 | MA | NEIGHBORHOOD HLTH PLAN | OTHER | 04 2297845 | 01 | MA | DOC FIRST | OTHER | 04 2297845 | 01 | MA | PRIVATE HEALTHCARE SYSTEM | OTHER | 04 2297845 | 01 | MA | UNITED HEALTH CARE | OTHER | 66933 | 01 | MA | HVD PILGRIM HEALTH CARE | OTHER | B10349001 | 01 | MA | CIGNA | OTHER | 04 2297845 | 01 | MA | GREAT WEST HEALTH CARE | OTHER | 36394 | 01 | MA | FALLON | OTHER | J18873 | 01 | MA | BCBS | OTHER | 04 2297845 | 01 | MA | GIC UNICARE | OTHER |